Epidemiology, presentation, diagnosis, and outcomes of choledochal cysts in adults in an urban environment

Wiseman, Kevin; Buczkowski, Andrzej K.; Chung, Stephen W.; Francoeur, Jason R.; Schaeffer, David F.; Scudamore, Charles H.

doi:10.1016/j.amjsurg.2005.01.025

Cited by 147 publications

(152 citation statements)

References 15 publications

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“…When the cyst extends into or involves the intrahepatic biliary tree (type IV-A and type V) complete cyst excision may not be possible 14 . In this study, 4 of 5 choledochal cysts gone to surgery following PTBD-E (cases 1, 4, 5) or PTBD-IE (case 2).…”

Section: Discussionmentioning

confidence: 99%

Çocukluk Çağı Benign Hastalıklarında Perkütan Transhepatik Biliyer Girişimler

Çeliktaş¹

2015

Cukurova Medical Journal

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Purpose: Percutaneous transhepatic biliary interventions are performed safely and effectively in adults. There is less experience of these interventions in benign diseases of children. We aimed to evaluate the safety and efficacy of percutaneous biliary interventions in benign diseases of children. Materials and Methods: In this retrospective study, percutaneous biliary interventions were performed in fifteen children with a mean age of 10.2 years (range 14 days-14 years). Patients presented with jaundice (n=5) and/or cholangitis (n=10). Percutaneous transhepatic biliary drainage (PTBD) performed in 10 patients, PTBD plus balloon dilation in 3, percutaneous cholecystostomy (PC) in 1, PTBD following PC in 1. Results: All procedures were technically successful. No procedure-related mortality occurred in patients. Serum bilirubin levels returned to normal or near normal in ten of twelve cases. Preexisting cholangitis and acute cholecystitis resolved in all patients. Six patients underwent surgery following percutaneous management. Nine patients cured primarily with percutaneous interventions with no further treatment. Conclusion: Percutaneous biliary interventions can be performed effectively in benign diseases of children. It can be performed either as a primary treatment modality or as a bridge prior to surgery. In most of cases, percutaneous treatment is sufficient and unnecessary surgery is prevented.

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Section: Discussionmentioning

confidence: 99%

Çocukluk Çağı Benign Hastalıklarında Perkütan Transhepatik Biliyer Girişimler

Çeliktaş¹

2015

Cukurova Medical Journal

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“…During pregnancy CC are atypical and represent an additional challenge, including fetal cyst-related risk from complications [7]. The incidence of choledochal cysts is 1 in 150,000 live births, of which 20% is detected in adulthood, affecting women with a ratio of 4:11 [8]. CC is an expansion of the intrahepatic or extrahepatic biliary ducts, classified by Todani into five types, which can lead to complications like biliary stasis, stone formation, cholangitis, pancreatitis and malignant degeneration [1].…”

Section: Discussionmentioning

confidence: 99%

Pancreatitis Secondary to Bile Duct Cyst in a 36-year-old Pregnant Woman: Case Report

R¹,

SS²

2015

Emerg Med (Los Angel)

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Pancreatitis in pregnancy has a prevalence of 1.5/1500-4500 cases, constituting one of the most common acute abdomen wedges, with biliary origin in 70% of cases, triglycerides in 20% and other causes in the remaining 10%, including choledochal cyst (CC) as a rare cause with three previous reports in literature, which may have a fatal outcome with fetal loss in some cases.We report the case of a 25-year-old patient with 30.4 weeks of gestation (WOG) that arrived to emergency room with right upper quadrant and epigastric pain for the last 8 hours, associated with nausea and vomiting. No pathological background referred. At physical examination with jaundice, gravidic abdomen for 30.4 WOG pregnant, fetal movements presents, Murphy (+) and epigastric pain on deep palpation. Laboratories report total bilirubin (TB) 3.9 mg/dl and direct bilirubin (DB) 3.69 mg/dl Alkaline phosphatase (AP) 2038 IU/L Amylase 280 IU/L Lipase 1938 IU/L. Pancreatitis is confirmed and abdominal ultrasound (US) is requested to determine biliar origin. USG reports gallbladder of 9×4 cm, thin walls without filling defects, dilated intrahepatic bile duct and common bile duct cyst. Cholangiopancreatography Resonance Imaging (CPMR) concludes Todani I choledochal cyst of 17×9 cm, with displacement of duodenum, colon and páncreas. Due to gestation ongoing appropriate medical management with fluids and analgesics was started until remission of pancreatitis 72 hours later. After delivery at 34 WOG, cholecystectomy was performed with hepático-jejunum Roux-Y anastomosis successfully. Histopathologic analisis reports inespecific inflammation without displasia or metaplasia. At four months follow-up patient is asymptomatic.Pancreatitis in pregnancy is a common cause of acute abdomen, rarely associated with choledochal cysts as the cause. Surgical resolution once pregnancy is over must be done as soon as possible by the high risk of adenocarcinoma degeneration and recurrent pancreatitis.

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“…Female to male ratio is from 3:1 to 5:1 (1,3,(5)(6)(7)(8)(9). Only approximately 20% of cysts are diagnosed in adults; they are more common in children (1). Incidence of bile duct cysts is variable and ranges from 1:100 000 to 1:150 000 in Western countries versus 1:1000 in Asian countries (Japan, China) (10).…”

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confidence: 99%

“…The most typical signs and symptoms include: abdominal pain, nausea and vomiting, jaundice, fever, cholangitis, pancreatitis, rarely an abnormal epigastric mass. The most common out of the above mentioned signs and symptoms is abdominal pain (1)(2)(3)(4)(6)(7)(8)(9). Triad of signs and symptoms that includes: abdominal pain, jaundice and palpable epigastric mass, is found occasionally (1)(2)(3)(4)(6)(7)(8)(9).…”

mentioning

confidence: 99%